Building Attendance Log for Contact Tracing Form

Before filling out this form, if you are experiencing COVID-19 Symptoms:

  • Cough, shortness of breath
  • Difficulty breathing, fever
  • Chills, repeated shaking with chills
  • Muscle pain, headache
  • Sore throat, new loss of taste or smell

You should:

  1. Not report for work
  2. Contact your personal physician or call the UConn Health COVID-19 Call Center at 860-679-3199 for further guidance
  3. Contact your manager or supervisor

All field marked with an asterisk (*) are required.

  • Date Format: MM slash DD slash YYYY
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